Not scheduled (OTC)

Topical

• Lotion: Calamine 8% w/v with zinc oxide 8% w/v (most common)

• Cream: Various proprietary blends (concentrations vary by brand)

• Ointment: Various proprietary blends

• Fixed-dose combinations: Calamine with diphenhydramine, camphor, or light liquid paraffin (check individual product labels)

INDICATIONS + DOSING — FOR CLINICIAN USE ONLY

Primary Indications (Approved / Standard in India)

Indication Dosing

Pruritus (insect bites, chickenpox, mild eczema, heat rash, urticaria) Application: Thin layer to affected area
Frequency: 2–3 times daily
Duration: Until symptoms resolve (usually 3–7 days)
Maximum: No defined maximum; avoid prolonged continuous use beyond 2 weeks

Mild sunburn / Superficial skin irritation Application: Thin layer to affected area
Frequency: 2–3 times daily
Duration: Until symptoms resolve
Note: Shake lotion well before use

Key Clinical Notes:

• Do not apply on broken skin, open wounds, or weeping lesions

• Do not apply to mucous membranes

• Avoid covering large body surface areas in infants

Secondary Indications – Adults (Off-label, if any)

Not documented

PAEDIATRIC DOSING (Specialist Only)

Primary Indications (Approved / Standard in India)

Age Group Dosing Notes

< 6 months Not recommended Use only under paediatric specialist supervision

6 months – 2 years Thin layer to affected area, up to 2 times daily Limit to small surface areas only; monitor for excessive dryness

2 years Thin layer to affected area, 2–3 times daily Same as adult dosing; limit to affected areas

Safety Monitoring:

• Monitor for skin dryness, irritation, or redness within 48 hours of first application

• Discontinue if signs of contact dermatitis appear

• Avoid application over large body surface area due to percutaneous absorption risk

Secondary Indications – Paediatric (Off-label, if any)

Not documented

Not applicable (topical agent with negligible systemic absorption)

Not applicable (topical agent with negligible systemic absorption)

• Known hypersensitivity to calamine, zinc oxide, or any excipient

• Open wounds, raw or weeping lesions

• Extensively denuded skin areas

• Application on mucous membranes

• Extensive use in neonates or premature infants

• Use with caution in children under 2 years of age

• Avoid contact with eyes; if accidental contact occurs, rinse thoroughly with water

• Prolonged or excessive use may lead to skin dryness or irritation

• Do not apply under occlusive dressings

• Some FDC formulations contain diphenhydramine or camphor — check for additional precautions

• Avoid use on acutely inflamed or infected skin without treating underlying cause

Parameter Details

Safety Considered safe for topical use

Recommendation May be used during pregnancy with standard precautions

Precautions Avoid application over large body surface area or broken skin

Monitoring Monitor for local skin irritation

Alternatives Generally first-line for pruritus in pregnancy; emollients also safe

Parameter Details

Compatibility Compatible with breastfeeding

Precautions Avoid application on nipple or areola area; if applied, wash off before feeding

Transfer to milk Negligible systemic absorption; minimal to no risk to infant

Infant monitoring Not required under normal use

• Safe for use in elderly patients

• Elderly skin may be more fragile and prone to dryness — limit duration of use

• Monitor for excessive dryness, irritation, or skin breakdown with prolonged use

• No dose adjustment required

Not applicable (topical agent with no systemic absorption; no significant drug interactions reported)

• No clinically significant interactions documented

• If using FDC formulations containing diphenhydramine or other active agents, refer to individual component interactions

• Skin dryness or scaling

• Mild stinging or burning sensation on application

• Temporary cooling or tingling sensation

• Mild erythema at application site

• Contact dermatitis (rare) — discontinue use if suspected

• Allergic hypersensitivity reaction (very rare) — discontinue immediately

• Persistent erythema or skin breakdown — discontinue and evaluate for alternative diagnosis

Phase Monitoring

Baseline Not required

After initiation Observe for local skin irritation or hypersensitivity within 24–48 hours

Long-term Not intended for extended continuous use; reassess if symptoms persist beyond 2 weeks

• Calosoft Lotion

• Lactocalamine Lotion

• Calak Lotion

• Calamyl Lotion

• Calamine IP (generic)

• Widely available OTC

• Not under NPPA price control (not in NLEM)

• Generic formulations available at lower cost

1. First-line choice for symptomatic relief of pruritus in children and adults — safe, inexpensive, and widely available

1. Shake well before use — calamine tends to settle at the bottom of lotion bottles

1. Supportive only in chickenpox — provides itch relief but has no antiviral activity; do not delay antiviral therapy if indicated

1. Avoid confusion — "calamine lotion" differs from antihistamine creams; check labels for added ingredients (diphenhydramine, camphor) which may have additional effects/side effects

1. Limit use in infants — increased risk of percutaneous absorption; use sparingly on small areas only

1. Drying effect — not ideal for already dry or xerotic skin; consider emollient-based alternatives in such cases

Calamine; pruritus; antipruritic; dermatology; topical; OTC; paediatric-safe; pregnancy-safe; lactation-safe; skin protectant; chickenpox; insect bites

RxIndia v0.2 — 07 Apr 2025

• Indian Pharmacopoeia (IP)

• CDSCO approved formulation data

• AIIMS Hospital Formulary

• API Textbook of Medicine — Dermatology Section

• IAP Guidelines — Atopic Dermatitis and Skin Care in Children

• Standard dermatology textbooks used in Indian medical education